When it comes to contraception and abortion access, the choice is stark

By Associate Professor Louise Keogh
Faculty of Medicine, University of Melbourne

The Coalition does not see access to sexual and reproductive services as either an election issue, or a priority for their next term; while the ALP is promising to wade into this currently disjointed, uneven and inequitable space.

There are very different laws and levels of service provision around Australia

Abortion laws and the provision of sexual and reproductive health services have traditionally been seen as state responsibilities, so each state has different laws relating to abortion and differing levels of service provision.

For example, in Australia’s most populous state, New South Wales, abortion remains a crime, although a woman can legally obtain an abortion if her doctor believes her physical and/or mental health is in danger. Other states and territories allow abortions within different specified gestation periods.

Access to services is patchy and varies widely. For example, while abortion is legal in Tasmania, surgical abortion is not available at all, requiring women to travel interstate to access this service.

Late terminations are especially difficult to access in the public system. The Victorian reproductive health service, 1800 MyOptions, states, ‘There are a very limited number of services that provide abortions after 12 weeks.’ Increasingly, the reason for needing a late termination is the detection of a fetal abnormality - so having the states in charge and leaving each hospital to make its own policy in this area has been hit and miss at best.’

Even when there are local services, the cost can rise steeply as gestation progresses, hampering access for some women. A medical abortion within the first nine weeks of pregnancy can be accessed for $250-350, while a surgical abortion within the first 12 weeks (which is covered by a Medicare rebate) can incur out-of-pocket costs ranging from $350-$550.

This situation does not align with community expectations. Most Australians accept that abortion is a necessary part of the health service, and support women’s right to choose. We are far from achieving best practice everywhere in this country, even as defined by conservative bodies like the World Health Organisation.

Labor policy

Labor has promised to ‘deliver Australia’s first ever National Sexual and Reproductive Health Strategy to make sure all Australian women can access legal, safe, affordable reproductive health services.

The ALP has outlined a $9.5m program, which would include:

  • lead progress towards national decriminalisation of abortion.
  • support all women to access termination services in public hospitals. Public hospitals (except Catholic hospitals that refuse to offer abortions on religious grounds) be encouraged to offer access to abortions to qualify for federal money
  • establish a new Tasmanian Reproductive Health Hub so women are not forced to travel interstate for a termination.
  • improve access to effective contraceptives to reduce rates of unplanned pregnancies, by reviewing the Medicare rebate for long-acting reversible contraceptives.
  • ask the Therapeutic Goods Administration to advise government on options to reduce barriers to improve access to the contraceptive pill.
  • support medical practitioners who prescribe medical terminations through a new online community of practice, so that GPs can access peer support and advice, as well as connect with pharmacists and other service providers.
  • review Medicare rebates associated with medical terminations to address access and affordability issues.
  • fund a national telephone referral service linking women to safe, credentialed providers of termination services.
  • restore funding to the Australian Women’s Health Network, enabling it to act as a voice for women on reproductive health access.

Coalition policy

The Prime Minister Scott Morrison has said abortion services are “rightly being dealt with by the states and territories”; and that public discussion about abortion does not “unite” the nation.

However, Health Minister Greg Hunt has announced a very small fraction of the $52.2m to improve women’s health will be for reproductive health, allocating ‘more than $4 million for reproductive and family planning organisations’

The announcement does not specify which organisations the money will be given to, but the Department of Health is reported as saying:

"More than $4 million over four years will go to four family planning organisations: Victorian Assisted Reproductive Treatment Authority (VARTA), the Ovulation Method Research and Reference Centre of Australia (Billings LIFE), Fertility Education Australia, and the Multicultural Centre for Women’s Health"

VARTA helps women get pregnant, Billings Life helps women use the so-called ‘Rhythm’ or ‘Billings’ method to either get pregnant or avoid pregnancy; Fertility Education Australia is formally associated with the Australian Catholic Bishops Conference, and the Multicultural Centre for Women’s Health has a broad range of activities, only one of which is sexual and reproductive health.

Coalition - Primary Policy Documents

Women's health

Labor - Primary Policy Documents

Women's reproductive rights

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